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Packagehl7.fhir.us.davinci-crd.r4b
Resource TypeValueSet
IdValueSet-coverageDetailCategories.json
FHIR VersionR4B

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Narrative

Note: links and images are rebased to the (stated) source

Generated Narrative: ValueSet coverageDetailCategories

  • Include these codes as defined in http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes
    CodeDisplayDefinition
    cat-limitationCoverage LimitationThe statement being made about coverage or authorization that are being constrained in scope in some way. I.e. It is not safe to interpret the statements of 'this is covered' or 'this does not require prior auth' without looking at this detail.
    cat-decisionalDecision ConsiderationsThe statement does not qualify the coverage statement, however it does provide information that may be relevant to the patient & caregiver decision of whether a therapy is appropriate/reasonable.
    cat-otherOther DetailsThe statement does not limit the coverage statement being made and is unlikely to influence a decision to proceed with care. For example, instructions on how to submit a claim, reference to to policy, etc.

Source1

{
  "resourceType": "ValueSet",
  "id": "coverageDetailCategories",
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger": 1
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "fm"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode": "trial-use",
      "_valueCode": {
        "extension": [
          {
            "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical": "http://hl7.org/fhir/us/davinci-crd/ImplementationGuide/davinci-crd"
          }
        ]
      }
    }
  ],
  "url": "http://hl7.org/fhir/us/davinci-crd/ValueSet/coverageDetailCategories",
  "identifier": [
    {
      "system": "urn:ietf:rfc:3986",
      "value": "urn:oid:2.16.840.1.113883.4.642.40.18.48.23"
    }
  ],
  "version": "2.2.0-ballot",
  "name": "CRDCoverageDetailCategories",
  "title": "CRD Coverage Detail Categories Value Set",
  "status": "active",
  "experimental": false,
  "date": "2025-08-06T17:27:13+00:00",
  "publisher": "HL7 International / Financial Management",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/fm"
        }
      ]
    }
  ],
  "description": "Codes that define the type of coverage information detail being provided",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "urn:iso:std:iso:3166",
          "code": "US"
        }
      ]
    }
  ],
  "compose": {
    "include": [
      {
        "system": "http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverage-information-codes",
        "concept": [
          {
            "code": "cat-limitation"
          },
          {
            "code": "cat-decisional"
          },
          {
            "code": "cat-other"
          }
        ]
      }
    ]
  }
}